Lecture 2 - opiates and alcohol

Question 1

How do the euphoric effects of opiates arises?

Answer 1

The effects are produced when the opioid receptors on the GABAergic neurons that inhibit dopaminergic neurons in the ventral tegmental area causing disinhibition and greater dopamine release from VTA presynapses terminating in the nucleus accumbens.

Question 2

List some opioid side effects.

Answer 2

Respiratory depression
Euphoria
Cough suppression
Nausea
Constipation

Question 3

List the short term effects of using opioids.

Answer 3

Analgesia
Sedation
Euphoria
Respiratory depression
Small pupils
Nausea, vomiting
Itching, flushed skin
Constipation
Slurred speech
Confusion

Question 4

What are the withdrawal symptoms experienced if opioids are stop?

Answer 4

Anxiety
Irritability
Craving for the drug
Rapid breathing
Diarrhea
Runny nose
Yawning
Abdominal cramps

Question 5

What drug is given if there is a case of opioid overdose?

Answer 5

The patient is put on IV fluids and then naloxone which is an opioid antagonist. It rapidly reverses respiratory depression and sedation.

Question 6

Which drugs are used for the drug replacement in drug abuse rehabilitation?

Answer 6

Methadone (longer lastin effects)
Buprenorphine/naloxone (4:1 ratio)
Clonidine and lofexidine (Alpha-2 adrenoceptor agonists)
Diacetyl morphine

Question 7

What are the different types of performance enhancing drugs?

Answer 7

Stimulants (amphetamine)
Anabolic steroids (nandrolone)
Diuretics (lower body weight)
Blood doping agents (EPO)

Question 8

How does EPO enhance performance?

What are the side effects and risks?

Answer 8

EPO is a hormone produced by the kidney to enhance oxygen in the blood during hypoxia 0 to 19 mU/ml.
Misuse can lead to thickening of the blood and also to autoimmune diseases.
Heart disease, stroke and cerebral or pulmonary embolism.

Question 9

List the scale of dependence for alcohol detoxification.

Answer 9

Mild dependence - <20 units: home with no drugs
Heavy dependence - >20 units: home with tranquilizers, chlordiaxepoxide.
Extreme cases: hospitalisation and drug administration

Question 10

What drugs are given for abstinence maintenance in alcohol abuse?

Answer 10

Acamprosate
Disulfiram (aldehyde dehydrogenase inhibitor)
Naltrexone (opioid antagonist)

Question 11

List a few coping strategies

Answer 11

Social situation: keep distance with people and situation that may impair recovery
Develop healthy habits: sleep early, eat health, exercise
Activities that doesnot involve alcohol: hobbies or past times.